Commenters Knock HHS Rules on Health Insurance Exchanges

The Urban Institute, a bipartisan research organization, suggested more people would enroll in exchanges if open enrollment was early in the year so consumers' could use their most current tax forms to establish eligibility. This could reduce administrative expenses spent to analyze and validate other income documentation, the Institute said.

Rep. Renee Elmers (R-NC), who serves on the House Committee on Small Business, said the proposed rule "does not address the fundamental issues of determining the essential benefits package or the standards for individual eligibility in the exchange. These yet-to-be-determined issues will be vital to insurers in setting rates and employers making insurance purchasing decisions."

The Patients' Access to Responsible Care Alliance is a Northern California group that advocates for the mentally disabled. The group said proposed rules about regional or subsidiary exchanges are too vague and could hinder access to medical care. It recommended that state laws regarding provider scope of practice terms apply to the regional and subsidiary exchanges.

The National Business Group on Health, which represents 330 large employers, suggested states "insulate the exchanges from politics" and "set up non-profit entities to administer exchanges rather than base them at new or existing state agencies." It said CMS should require states to "share eligibility and enrollment information from their individual and small business health options exchanges to allow both the exchanges and employers to better identify individuals transitioning from different coverage."

When the rules were first proposed in July, HHS said it expected to have the final rules in place before the end of the year. However, the comment period was extended by 30 days to Oct. 31, which could delay the final rules. Efforts to confirm a timeline for the final rules were unsuccessful.